Alcohol is a known teratogen which affects morphology as well as behavior. The effects of prenatal alcohol exposure range from fetotoxicity to behavioral alterations and growth deficits in non- dysmorphic children. Long term developmental outcomes in prenatally alcohol-exposed children include cognitive impairments, attentional and behavioral problems. Concurrent research on children of alcoholics suggests that the dysfunctional caretaking environment of an alcoholic home may contribute to the pattern and severity of deficits observed in such children. Furthermore, evidence from both retrospective and prospective studies suggests considerable individual variability in response among children prenatally exposed to alcohol. The proposed research is a prospective study on prenatal alcohol exposure which will examine concommitantly the effects of maternal pre and postnatal abuse of alcohol. The proposed study includes evaluations of developmental outcomes in 7 year old children known to have been exposed to alcohol prenatally. Three groups of children will be compared: children who were exposed to alcohol throughout gestation; children whose mothers discontinued alcohol use in the second trimester, but may have resumed alcohol use postpartum; and children whose mothers did not use alcohol pre or postnatally. In addition, the incidence of attention deficit disorder and learning disabilities will be evaluated in this high risk population. Differential diagnoses of conduct disorder and depression will also be made. Data collected as part of the proposed study will be combined with archival data on birth status and developmental outcomes at 6, 12, 24 months and 5 years and will be used to develop a conceptual model of the effects of maternal pre and postnatal alcohol abuse. It is hypothesized that children with a demonstrated vulnerability to alcohol as defined by negative infant status will be more adversely affected by environmental factors.